A 25 year- old female presents to the primary care office with urinary burning and frequency for the last
3 days. She denies any fever, chills, back pain. Her gynecological history is negative and reports no
vaginal discharge. The only new information reported is that she recently had sexual intercourse with a
new male partner.
The NP obtains a urinalysis and determines that the urine contains leukocytes, RBCs, nitrites, and WBCs.
No casts are identified. Based on symptom presentation and UA results, the patient can be diagnosed
with:
cystitis
J.S. is an 80 -year-old patient who resides in a local nursing home. He recently became confused and
then fell while ambulating to the bathroom three days ago. Because of his confusion and fall, he was
transferred to the acute care facility for evaluation and treatment. Lab work revealed that the patient
was very dehydrated with hypernatremia identified and appropriate intravenous fluids started. Cystitis
was also identified from the urinalysis. He was also noted to have red and excoriated skin between the
,NR 507 ADVANCED PATHOPHYSIOLOGY
buttocks and inner thighs due to urinary frequency and dribbling. To help with skin healing and to
prevent further urine leakage, an indwelling catheter was inserted. Two days after the catheter was
placed, the patient spiked a fever of 102 degrees Fahrenheit associated with shaking chills. An intense,
foul odor was noted in the urine. On examination of the flank area, the patient yelled out when touched.
A urine culture was obtained and came back positive for nitrites and RBCs. Urine microscopy revealed
>100,000 WBC/hpf and casts.
Based on the information provided in the case, the patient can most likely be diagnosed with:
pyelonephritis
Identify the major risk factor J.S. has that is associated with pyelonephritis:
indwelling foley catheter
The urinalysis of a patient with a complicated UTI will show WBCs and casts
true
Upon examination of a urinalysis, the NP can highly suspect that the causative bacteria are gram
negative because of the presence of:
nitrites
A 21-year-old patient reports to the primary care clinic complaining of urinary urgency, frequency and
burning. She also reports a small amount of vaginal discharge that contains an odor. It is likely that the
NP will perform a vaginal exam at this visit.
true
, NR 507 ADVANCED PATHOPHYSIOLOGY
The NP would know that the patient most likely has an uncomplicated UTI because:
The UTI responds well to a short course of antibiotic therapy.
A common organism that causes a urinary tract infection include:
Staphylococcus saprophyticus.
E coli
The purpose of straining in BPH is to overcome the obstruction encountered during urination.
true
The peripheral zone of the prostate is the largest zone.
true
On a digital rectal exam to assess the quality of the prostate, the NP would be concerned with which of
the following findings?
hard nodule
There is a significant risk for men with benign prostatic hyperplasia (BPH) to develop cellular mutations
that lead to prostate cancer.
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